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JKC Med Phys Spring '24 > Cardio- Exam 2 > Flashcards

Cardio- Exam 2 Flashcards

1
Q

What two systems control the pH?

A

Respiratory and renal

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2
Q

If the problem is respiratory, the compensation will be ______?

A

Renal

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3
Q

If the insulin is low, _____ are being metabolized very rapidly

A

fats

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4
Q

If H are being liberated (aka being introduced), the equation moves to the ____?

A

Left

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5
Q

If you have lung disease and cannot blow off CO2, the equation moves ???

A

Right

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6
Q

If you are building up an excess of CO2, what do you need to do with bicarb?

A

Bicarb needs to be reabsorbed by the kidneys

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7
Q

When latic acid is introduced (due to 400 meter dash, etc), causes ____.

A

metabolic acidosis

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8
Q

bicarb will (increase/decrease) when you are blowing off large amount of CO2?

A

bicarb will decrease

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9
Q

By looking at this chart, how do you determine if the reason for pH imbalance is during to something metabolic?

A

By looking at the bicarb

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9
Q

What is the Henderson Hasselbach equation?

A
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10
Q

**What is magic number for bicarb?

A

24

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11
Q

What does it mean if the patient’s values do NOT fall within the blue area?

A

There is more than one cause of there pH imbalance

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12
Q

**What is the partial pressure of CO2?

A

40

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13
Q

When you are running, why do you start breathing faster?

A

to get rid of the excess CO2 (acid) building up in your body due to exercising

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14
Q

When you are metabolic alkalosis, the bicarb will be ____.

A

Bicarb will be HIGHER than 24

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15
Q

When you are metabolic acidosis, the bicarb will be ____.

A

Bicarb will be LESS than 24

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16
Q

What are the three major collections of neurons that make up the control center?

A

Dorsal Respiratory Group
Ventral Respiratory Group
Pneumotaxic Center

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17
Q

______ is responsible for causes inspiration

A

Dorsal respiratory Group

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18
Q

_____ mainly causes expiration

A

Ventral Respiratory Group

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19
Q

______ mainly controls rate and depth of breathing

A

Pneumotaxic center which advises the dorsal and ventral respiratory groups

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20
Q

Where does the dorsal respiratory group get its sensory information from?

A

Vagus and Glossopharyngeal nerves

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21
Q

______, ______, and ______ transmit sensory signals into the respiratory center from the dorsal respiratory group

A

Peripheral chemoreceptors
baroreceptors
several types of receptors in the lungs

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22
Q

When do you stop taking air in, is controlled by the _____

A

Pneumotaxic center

controls the “switch off” point

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23
Q

When the pneumotaxic sign is strong the inspiration is _____

A

Short (.5 seconds) and filling is slight

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24
Q

When the pneumotaxic sign is weak the inspiration is _____

A

might continue for 5 or more seconds

lungs fill with great excess of air

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25
Q

A strong pneumotaxxic signal can increase the rate of breathing to ______.

A

50 breaths per minute

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26
Q

A weak pneumotaxic signal may reduce the rate _____

A

to only 3 to 5 breaths per minute

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27
Q

What is the main function of Pneumotaxic center?

A

To limit inspiration

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28
Q

______ remain almost totally inactive during normal quiet respiration

A

Ventral group of neuron

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29
Q

______ do not appear to participate in the basic rhythmical oscillation that controls respiration

A

Ventral Group of Neurons

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30
Q

Where are the stretch receptors located?

A

in the muscular portions of the walls of the bronchi and bronchioles

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31
Q

How do stretch receptors transmit signals? Where are they headed?

A

through the vagus nerve

into the Dorsal Respiratory Group

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32
Q

The _____ prevents over inflation of the lungs

A

Hering-Breuer Inflation Reflex

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33
Q

When the lungs becomes overstretched, what 2 things happen? Define overstretched?

A

-Creates a “switch off” of the inspiratory ramp
-Also increases the rate of respiration

When TV > 1.5 (x3)

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34
Q

In a normal healthy human being, ____ is the limited factor

A

Heart, NOT lungs

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35
Q

When it comes to CENTRAL chemical control in the brain, ____ is more important than ____

A

CO2 is MORE important than O2

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36
Q

______ acts almost entirely on the peripheral chemoreceptors. Where are they located?

A

Oxygen

carotid and aortic bodies (oxygenated blood), transmit nervous signals to the respiratory centers

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37
Q

Where is the direct chemical control located?

A

in the chemosensitive area just beneath the ventral surface of the medulla

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38
Q

What is the role of the peripheral chemoreceptors?

A

to detect the partial pressure of oxygen in the body

at sea level under normal circumstances, the peripheral chemoreceptors are not doing anything. Only activated if there is a problem.-> Lungs disease due to excessive coal mining (alveolar damage) and high altitude might cause the peripheral carotid bodies to detect a lower partial pressure of oxygen in the blood

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39
Q

The direct chemical control is highly sensitive to ____ and _____

A

Blood PCO2 and Hydrogen ion

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40
Q

_____ is the likely primary stimulus after CO2 converts to H and bicarb ion

A

H

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41
Q

(H/CO2) crosses the blood brain barrier better

A

CO2 crosses better than H

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42
Q

When blood CO2 increases, PCO2 _____ in cerebrospinal fluid. Then what happens?

A

also increases

Immediate reaction with water to form H

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43
Q

Where are peripheral chemoreceptors located outside of the brain?

A

-most are located in carotid bodies

  • few in the aortic bodies
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44
Q

What is the flow from a carotid body to the dorsal respiratory area of the medulla?

A

Carotid bodies -> bifurcations of the common carotid arteries - > pass through Hering’s nerves -> to the glossopharyngeal nerves -> to the dorsal respiratory area of the medulla

45
Q

What is the flow from a aortic body to the dorsal respiratory area of the medulla?

A

Aortic bodies- > located along the arch of the aorta- > vagus nerves -> dorsal medullary respiratory area

46
Q

An increase in CO2 or H also excites the chemoreceptors. Is it stronger in the brain or peripheral?

A

7X stronger effect in the brain

47
Q

____ AND ____ are responsible for regulating ventilation in healthy humans at sea level

A

PCO2 and H+

48
Q

T/F: You have chemoreceptors in your muscles and joints

A

True

49
Q

What are the chemoreceptors in your muscles/joints called?

A

Mechano/ Metabo receptors

50
Q

What is the name of the receptor that is responsible for the feeling of suffocation? or dyspnea in CHF.

A

J receptors

51
Q

Head trauma can cause the brain to swell, which causes? How do you treat it?

A

swelling causes compression of the cerebral arteries

Intravenous injection of hypertonic solutions or osmotically remove some of the fluids in the brain relieving the pressure

52
Q

What is Cheyne- Stoke breathing?

A

When you blow off to much CO2 and take in too much O2

usually heard in dying patients

53
Q

Sleep apnea is caused by ??

A

obstruction of the upper airways

build up of CO2

54
Q

When V/Q is low, what direction does the Oxygen dissociation curve shift to?

A

Shifts to the right

55
Q

When the V/Q is high, what direction does the oxygen dissociation curve shift to?

A

Shifts to the left

56
Q

acidity or heat, will shift the Oxygen dissociation curve to ??

A

Shift to the right

57
Q

High altitude or base, will shift the Oxygen dissociation curve to ??

A

Shift to the left

58
Q

shifting Right or Left, will cause more oxygen to be dumped off at the tissues?

A

shifting to the right

59
Q

Cardiac muscles muscle contraction is longer/shorter than skeletal muscle

A

much longer

60
Q

_____ (part of the heart) exhibits automatic rhythmical electrical discharge in the form of action potentials

A

SA node

61
Q

______ form permeable gap junctions that allow rapid diffusion of ions

A

Intercalated discs

62
Q

What does a functional syncytium mean?

A

if one heart muscle fiber contracts they all contract

63
Q

What are the 2 syncytia of the heart

A

Atrial and ventricular

64
Q

the sodium/calcium channel in skeletal muscle is (faster/slower) than heart

A

much faster in skeletal muscle

65
Q

In cardiac muscle, the calcium/sodium channels are ____.

A

slow and remain open for several tenths of a second

66
Q

T/F: The heart uses the same excitation contraction coupling as skeletal muscles

A

TRUE

67
Q

**the ______ action potentials in turn act on the membranes of the _______ to cause release of calcium

A

T Tubule

Longitudinal sarcoplasmic tubules

68
Q

____ is used to increase the strength of the heart muscle contraction

A

Calcium

69
Q

Action potential spreads to the interior of the cardiac muscle fiber along the membranes of the ______

A

Transverse (T) tubules.

70
Q

The Strength of contraction of cardiac muscle depends on the _____ in the extracellular fluids.

A

[calcium ions]

71
Q

B- Adrenergic stimulation _____ in force and ____ in rate of heart muscles

A

Increases force of heart muscle contraction

Increase rate of contraction

72
Q

Why is it important that B adrenergic stimulation increases heart rate and force?

A

because it allows for greater relaxation time. aka more time for the ventricles to fill with blood

73
Q

How does the B Adrenergic stimulation get the heart to contract stronger?

A

by increasing the amount of calcium in the cell

74
Q

Cyclic AMP stimulates an inactive protein kinase to become _____

A

active protease kinase

75
Q

_____ goes throughout the cell and changes the calcium dynamics.

A

active protease kinase

76
Q

_____ stimulates an inactive protein kinase to become active protein kinase

A

Cyclic AMP

77
Q

_____ exists in the cardiac myocytes that is present on T -Tubules that allows the calcium to go from extracellular to intercellular

A

L type channel

78
Q

TnI- P is what? What does it do?

A

Troponin I (inhibition)

delays the relaxation in contraction process, causes relaxation to be longer and a more forceful but shorter contraction

79
Q

what cardiac enzyme (protein) is measured after a MI to determine damage?

A

looking at Troponin I levels

80
Q

DHP is related to ???

A

blood pressure

block calcium release aka calcium channel blockers

81
Q

Ryanodine receptors are responsible for??

A

responsible for the release of Ca2+ from intracellular stores during excitation-contraction coupling in both cardiac and skeletal muscle

82
Q

Amiodarone is what class? What does it do?

A

Class III

Prolongs phase III of the cardiac action potential, the repolarization phase where there is normally decreased calcium permeability and increased potassium permeability

83
Q

Parasympathetic stimulation of the heart does what??

A

decreases the heart from 100 to about 65

84
Q

Parasympathetic (Vagal) stimulation does what 3 things to the heart?

A
  1. decrease rate of depolarization
  2. increase in AP hyperpolarization
  3. increase threshold for contraction, making it longer to get to threshold
85
Q

The intrinsic cardiac regulation is what?

A

heart will pump the same amount of blood it receives

86
Q

Be able to draw this

A
87
Q

The Frank- Starling mechanism is ???

A

the amount of blood pumped by the heart is determined by the rate of blood flow into the heart from the veins

the heart can adapt to increasing volumes of inflowing blood

88
Q

the great the heart muscle is stretched during filing, the _____ the force of contraction

A

greater the force of contraction

the greater the quantity of blood pumped into the aorta

89
Q

T/F: The organs receive and maintain their own blood supply

A

True: the organ can regulate its own blood flow without the help of hormones, nervous system etc etc

90
Q

define preload

A

loading up blood before the contraction occurs

91
Q

define afterload

A

the amount of pressure the heart has to create to eject the blood

92
Q

Things that effect preload

A
  • muscle pump (muscle constriction)
  • respiratory pump (breathing)
  • moving around (dynamic work)
  • venoconstriction (sympathetic NS)
93
Q

Things that effect afterload

A
  • Static work (weight lifting, standing still shoveling snow)
    -Increase in amount of contraction needed to pump blood out of the heart
  • High SBP
    -Aortic stenosis
  • Arteriorsclerosis
94
Q

The heart can increase in size of the _____

A

ventricle

95
Q

preload problem, does the atrium or ventricle get larger?

A

ventricular chamber gets larger

96
Q

Would a long distance runner or weight lifter be more likely to have a LARGER left ventricle

A

Preload (dynamic work) runners

97
Q

Eccentric hypertrophy is associated with (preload/afterload) is most commonly found in (weightlifters/runners)

A

preload

runner

98
Q

Concentric hypertrophy is associated with (preload/afterload) is most commonly found in (weightlifters/runners)

A

Afterload stress

weightlifters

99
Q

In eccentric contraction what is happening to the muscle?

A

it is getting longer when its contracting

100
Q

In concentric contraction what is happening to the muscle?

A

muscle is getting bigger, muscle is getting shorter when stretched

101
Q

Afterload is an increase in _____

Preload is an increase in ____

A

Muscles in the ventricle

size of ventricles itself

102
Q

Heart is supplied with both _____ and _____ nerves

A

parasympathetic

sympathetic

103
Q

The parasympathetic nerves mainly go to the ____ and _____

A

SA and AV nodes

few to the 2 atrium

(VERY FEW to the ventricular muscles)

vagus nerve

104
Q

Sympathetic nerves mainly go to ???

A

all parts of the heart but lots go the ventricular muscles

105
Q

What happens if the sympathetic nerve is inhibited?

A

decreased cardiac pumping to a moderate extent. Heart rate and strength of contraction decrease by 30%

106
Q

Chronotropic

A

how fast your heart is beating (HR)

107
Q

Ionotrophic

A

how hard the heart is beating

108
Q

Strong stimulation of the parasympathetic nerve has what effect on the heart?

A

fibers in the Vagus nerves to the heart can stop the heartbeat for a few seconds

109
Q

what effect does strong Vagal stimulation have on the heart?

A

can decrease the strength of heart muscle contraction by 20 to 30%

110
Q

What is the Fick equation

A
111
Q

Know this picture

A

Be able to draw this picture

JKC Med Phys Spring '24 (18 decks)

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